Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $43.65 / $83.18 / $194.98	Facility		$43.65	$83.18	$194.98
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $41.69 / $58.88 / $354.81	Facility	50	$41.69	$58.88	$354.81
Aetna Facility/Professional Professional Modifier Low / Median / High Price $30.20 / $63.10 / $208.93	Professional		$30.20	$63.10	$208.93
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $77.62 / $208.93 / $512.86	Professional	50	$77.62	$208.93	$512.86
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $34.67 / $95.50 / $151.36	Professional	52	$34.67	$95.50	$151.36
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,584.89 / $3,090.30 / $5,754.40	Facility		$1,584.89	$3,090.30	$5,754.40
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.71 / $85.11 / $199.53	Professional		$45.71	$85.11	$199.53
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $69.18 / $131.83 / $302.00	Professional	50	$69.18	$131.83	$302.00
CareSource Facility/Professional Professional Modifier Low / Median / High Price $104.71 / $104.71 / $104.71	Professional		$104.71	$104.71	$104.71
Cigna Facility/Professional Facility Modifier Low / Median / High Price $125.89 / $147.91 / $234.42	Facility		$125.89	$147.91	$234.42
Cigna Facility/Professional Professional Modifier Low / Median / High Price $51.29 / $102.33 / $162.18	Professional		$51.29	$102.33	$162.18
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $77.62 / $3,715.35	Facility		$32.36	$77.62	$3,715.35
DeanCare Facility/Professional Professional Modifier Low / Median / High Price $67.61 / $93.33 / $141.25	Professional		$67.61	$93.33	$141.25
Medica Facility/Professional Facility Modifier Low / Median / High Price $32.36 / $147.91 / $1,778.28	Facility		$32.36	$147.91	$1,778.28
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,096.48 / $1,096.48 / $1,096.48	Facility	50	$1,096.48	$1,096.48	$1,096.48
Medica Facility/Professional Professional Modifier Low / Median / High Price $48.98 / $89.13 / $354.81	Professional		$48.98	$89.13	$354.81
Molina Facility/Professional Professional Modifier Low / Median / High Price $32.36 / $33.11 / $85.11	Professional		$32.36	$33.11	$85.11
Quartz Facility/Professional Professional Modifier Low / Median / High Price $52.48 / $93.33 / $162.18	Professional		$52.48	$93.33	$162.18
Quartz Facility/Professional Facility Modifier Low / Median / High Price $100.00 / $2,951.21 / $2,951.21	Facility		$100.00	$2,951.21	$2,951.21
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $81.28 / $81.28 / $162.18	Facility	52	$81.28	$81.28	$162.18
Quartz Facility/Professional Professional Modifier Low / Median / High Price $38.02 / $138.04 / $346.74	Professional		$38.02	$138.04	$346.74
Security Health Facility/Professional Professional Modifier Low / Median / High Price $93.33 / $181.97 / $269.15	Professional		$93.33	$181.97	$269.15
United Facility/Professional Facility Modifier Low / Median / High Price $977.24 / $1,548.82 / $1,949.84	Facility		$977.24	$1,548.82	$1,949.84
United Facility/Professional Professional Modifier Low / Median / High Price $36.31 / $69.18 / $169.82	Professional		$36.31	$69.18	$169.82